title: Surgical approaches to hypothalamic hamartomas.
abstract: OBJECTIVE
  Hypothalamic hamartomas (HHs) are devastating lesions causing refractory epilepsy, rage attacks, social ineptitude, and precocious puberty. Microsurgical and/or endoscopic resection offers an excellent risk/benefit profile for cure or improvement of epilepsy.
  
  
  METHODS
  The authors reviewed a prospective database maintained during the first 7 years of the Barrow Hypothalamic Hamartoma program. They describe and illustrate their surgical methods, and they review data from several previous publications regarding surgical outcome.
  
  
  RESULTS
  To date, the authors have performed surgery in 165 patients for symptomatic HHs. Patients underwent an endoscopic, transcallosal, or skull base approach, or multiple approaches. Twenty-six patients (15.8%) required more than 1 treatment for their HH.
  
  
  CONCLUSIONS
  Microsurgical and endoscopic resection of symptomatic HHs are technically demanding but can be performed safely with excellent results and an acceptable risk profile. Meticulous attention to the subtleties of surgical management helps optimize outcomes.
authors.affiliation: Division of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona 85013, USA. scott.wait@bnaneuro.net
authors.forename: Scott D
authors.initials: SD
authors.lastname: Wait
authors.forename: Adib A
authors.initials: AA
authors.lastname: Abla
authors.forename: Brendan D
authors.initials: BD
authors.lastname: Killory
authors.forename: Peter
authors.initials: P
authors.lastname: Nakaji
authors.forename: Harold L
authors.initials: HL
authors.lastname: Rekate
mesh_terms: D003337:Corpus Callosum / Q000473:pathology / Q000601:surgery; D004724:Endoscopy / Q000379:methods*; D004827:Epilepsy / Q000209:etiology / Q000601:surgery; D005500:Follow-Up Studies; D006222:Hamartoma / Q000150:complications / Q000601:surgery; D006801:Humans; D007027:Hypothalamic Diseases / Q000150:complications / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods; D019635:Neurosurgical Procedures / Q000379:methods*; D016634:Radiosurgery / Q000379:methods*; D012189:Retrospective Studies; D019291:Skull Base / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome